Communication among healthcare professionals is critically important to provide safe care, as poor communication represents a major etiology of preventable adverse events (AE) in hospitals. Although interventions to improve communication and teamwork have been studied in a variety of medical settings, relatively little research has focused on improving teamwork at the most common site of hospital care-medical-surgical units. Important, unique barriers to effective communication among professionals exist on these units. Previous studies have shown that nurses and physicians do not communicate consistently and often disagree on the plan of care for their patients. This ineffective exchange of information and incomplete understanding of the plan of care contributes to an environment unprepared to intercept and/or prevent medical errors from causing harm to patients. The INTERdisciplinary Approaches to Communication and Teamwork (INTERACT) project will assess a multifaceted intervention designed to improve communication and teamwork on general medical hospital units. Our hypothesis is that broad implementation of the intervention will result in improved ratings of collaboration and teamwork and a reduction in the risk-adjusted rate of preventable AEs. The specific aims of the INTERACT project are: AIM 1. Broadly and successfully implement the intervention, Prepared Nurse-Physician Co- Leadership and Structured Inter-Disciplinary Rounds (SIDR), to improve communication and teamwork on general medical hospital units. AIM 2. Determine the impact of INTERACT on team members'ratings of interdisciplinary collaboration and teamwork using surveys adapted from the Safety Attitudes Questionnaire (SAQ). AIM 3. Determine the benefit of INTERACT in reducing the risk-adjusted rate of preventable AEs using established methods for medical record review. AIM 4. Produce and disseminate a toolkit based on INTERACT that other hospitals can use to implement interventions to improve interdisciplinary collaboration. Our findings will be of broad interest to acute care hospitals struggling to reduce AEs and improve collaboration on medical-surgical units. The knowledge acquired and tools developed will provide flexible, practical, and portable methods to sustainably improve care for a vast number of hospitalized patients. PUBLIC HEALTH RELEVANCE: Communication between nurses, physicians, other health care team members is critically important to provide safe and effective care. Although patterns of communication and interventions to improve teamwork have been studied in a variety of medical settings, very little research has focused on improving teamwork in the general medical inpatient setting. This project will assess a multifaceted intervention to improve communication and teamwork on general medical hospital units.